SAGE And The Truth Behind ‘The Science’

On Friday 24th April, under significant pressure from the media and public, the Scientific Advisory Group for Emergencies (SAGE) released a list of individuals who had attended it’s meetings. With deaths currently at 28,446, Britain is on track to become the country worst hit by coronavirus in Europe. From the outset of the crisis, the U.K. government has claimed to be following ‘the science,’ repeating this mantra as gospel to reassure the public. As the toll continues to rise, it’s becoming clear that the government did not take early or strict enough action, wasting precious days in pursuit of ‘herd immunity.’ It’s evident that in the early days of the pandemic, either the science was misguided, or the political interpretation of it was. Indeed, the pandemic has exemplified that science is not objective truth, but something to be questioned, disputed and debated. The lack of transparency surrounding the U.K. government’s Scientific Advisory Group for Emergencies (SAGE) is thus extremely troubling. In order for the correct course of action to be chosen, and for lives to be saved, it’s crucial that we are able to critique scientific advice and the way it is translated into politics. 

SAGE is an independent advisory body designed to provide scientific advice to policy-makers during emergencies. Twice a week, an independent panel of experts from across the scientific spectrum meet to discuss evidence and advise the government. Their proposals are then debated by ministers at the Cabinet Office Briefing Rooms (COBRA), who weigh the science against political factors to inform policy. However, over recent weeks, concerns have been raised over the independence and integrity of the body, including by the former Chief Scientific Adviser, Sir David King. These center on two major points – SAGE’s reluctance to be transparent, and the make-up of attendees in meetings. 

First and foremost, Sir Patrick Vallance has announced that SAGE will not publish the advice and data which is shaping the government’s coronavirus response until after the pandemic ends. Sir David King has voiced his concerns, stating that “science is a discipline based on peer review, therefore it is critical scientific advice is transparent.” The move has prompted a scathing backlash from across the scientific community, which argues that withholding this information not only impedes their ability to peer-review the advice given, but also to know whether policy is actually being led by the science. As Birmingham Yardley MP Jess Phillips remarked, “I want to know if the advice on, for example, mask wearing by the public is based on science or the lack of supply of masks.” Dozens of health experts have published a letter in the Lancet demanding that SAGE’s minutes be released immediately, but as of yet, their calls are unanswered. 

Richard Coker, professor of public health, has also expressed fears that SAGE may become subject to ‘groupthink,’ whereby intimacy and familiarity between members leads to the nurturing of ideas without sufficient criticism and questioning. Experts, he warns, can become “overconfident in their theories” that are “spun from meagre evidence,” creating an atmosphere which shuts down the voices of critics. Given that SAGE’s operations remain secretive, we have no way of knowing whether members are challenging their assumptions. 

SAGE’s list of attendees, which was only released under intense public pressure, only strengthens the argument for more transparency. Understanding the scientific make-up of SAGE is key in understanding the background of their recommendations. In theory, the panel should draw together top independent experts from different scientific disciplines. Whilst the list includes a number of senior members of the NHS, WHO, influenza academics, microbiologists and epidemiologists, it has been criticized for not including enough public health experts or mathematical modelers/statisticians. Meanwhile, there are numerous behavioural scientists on the board. There has been speculation that warnings of ‘lockdown fatigue’ – a behavioural theory that the public would get tired after a certain period and break rules, leading to a second spike in infections – delayed the implementation of stricter measures. In reality, the government has admitted that compliance with lockdown has been far greater than predicted. 

Disturbingly, the list revealed that Dominic Cummings has also attended meetings. The presence of the Prime Minister’s right-hand man has raised alarm bells for many scientists. It’s crucial that SAGE is robustly independent to ensure that advice given to politicians is impartial and unswayed by political motivations. Whilst it’s common for civil servants to attend meetings, the host of special advisers (employed directly by a political party) is unprecedented. Moreover, civil servants in attendance only observe discussions, and do not participate themselves. There have been reports of Cummings chiming in with debates, and that on the 18th March he lobbied SAGE to recommend that the U.K. implement lockdown measures. Given that Cummings has no scientific background, it’s unclear why he is permitted to attend meetings, let alone participate in scientific discussions. There are concerns that Cummings could direct the course of discussion, and that given his proximity to the Prime Minister, scientists may (consciously or not) defer to him. This was confirmed by an anonymous SAGE member, who said that “when a very senior civil servant or a very well-connected person interrupts, I don’t think anyone in the room feels the power to stop it.” Cummings’ presence undoubtedly compromises the independence of SAGE and the impartiality of ‘the science’ dictating government policy. 

Moreover, Cummings has been accompanied by fellow Downing Street adviser Ben Warner, alongside Demis Hassabis, co–founder of Google’s artificial intelligence division. Warner, a data scientist, worked together with Cummings on the Vote Leave campaign. His brother is CEO of Faculty, the AI company involved in data-mining as part of the government’s pandemic response. Hassabis is regarded as a world-leading expert in artificial intelligence; however, the presence of an executive from a company that is set to profit from the crisis through utilizing health data demands an explanation. 

Consequently, it was announced today that Sir David King is establishing an alternative independent panel of global experts to offer “robust, unbiased advice” on lifting lockdown. This is undeniably a step in the right direction. However, we must continue to be mindful of the source of this advice, asking who are the experts involved, and how have they come to their conclusions? Furthermore, there must be full transparency on how this scientific advice is interpreted politically. As Azeem Majeed of Imperial College tweeted, “when the government say their Covid-19 strategy is “led by the science” but then refuse to publish the minutes or membership of…SAGE or allow the members of SAGE to debate with its critics publicly, that’s dogma, not science.”